A prospective cohort study on ambient air pollution and respiratory morbidities including childhood asthma in adolescents from the western Cape Province: study protocol

Background: There is evidence from existing literature that ambient air pollutant exposure in early childhood likely plays an important role in asthma exacerbation and other respiratory symptoms, with greater effect among asthmatic children. However, there is inconclusive evidence on the role of ambient air pollutant exposures in relation to increasing asthma prevalence as well as asthma induction in children. At the population level, little is known about the potential synergistic effects between pollen allergens and air pollutants since this type of association poses challenges in uncontrolled real life settings. In particular, data from sub-Sahara Africa is scarce and virtually absent among populations residing in informal residential settlements. Methods/design: A prospective cohort study of 600 school children residing in four informal settlement areas with varying potential ambient air pollutant exposure levels in the Western Cape in South Africa is carried-out. The study has two follow-up periods of at least six-months apart including an embedded panel study in summer and winter. The exposure assessment component models temporal and spatial variability of air quality in the four study areas over the study duration using land-use regression modelling (LUR). Additionally, daily pollen levels (mould spores, tree, grass and weed pollen) in the study areas are recorded. In the panel study asthma symptoms and serial peak flow measurements is recorded three times daily to determine short-term serial airway changes in relation to varying ambient air quality and pollen over 10-days during winter and summer. The health outcome component of the cohort study include; the presence of asthma using a standardised ISAAC questionnaire, spirometry, fractional exhaled nitric-oxide (FeNO) and the presence of atopy (Phadiatop). Discussion: This research applies state of the art exposure assessment approaches to characterize the effects of ambient air pollutants on childhood respiratory health, with a specific focus on asthma and markers of airway inflammation (FeNO) in South African informal settlement areas by considering also pollen counts and meteorological factors. The study will generate crucial data on air pollution and asthma in low income settings in sub-Sahara Africa that is lacking in the international literature

Impact of COVID-19 in patients on active melanoma therapy and with history of melanoma

INTRODUCTION: COVID-19 particularly impacted patients with co-morbid conditions, including cancer. Patients with melanoma have not been specifically studied in large numbers. Here, we sought to identify factors that associated with COVID-19 severity among patients with melanoma, particularly assessing outcomes of patients on active targeted or immune therapy. METHODS: Using the COVID-19 and Cancer Consortium (CCC19) registry, we identified 307 patients with melanoma diagnosed with COVID-19. We used multivariable models to assess demographic, cancer-related, and treatment-related factors associated with COVID-19 severity on a 6-level ordinal severity scale. We assessed whether treatment was associated with increased cardiac or pulmonary dysfunction among hospitalized patients and assessed mortality among patients with a history of melanoma compared with other cancer survivors. RESULTS: Of 307 patients, 52 received immunotherapy (17%), and 32 targeted therapy (10%) in the previous 3 months. Using multivariable analyses, these treatments were not associated with COVID-19 severity (immunotherapy OR 0.51, 95% CI 0.19 - 1.39; targeted therapy OR 1.89, 95% CI 0.64 - 5.55). Among hospitalized patients, no signals of increased cardiac or pulmonary organ dysfunction, as measured by troponin, brain natriuretic peptide, and oxygenation were noted. Patients with a history of melanoma had similar 90-day mortality compared with other cancer survivors (OR 1.21, 95% CI 0.62 - 2.35). CONCLUSIONS: Melanoma therapies did not appear to be associated with increased severity of COVID-19 or worsening organ dysfunction. Patients with history of melanoma had similar 90-day survival following COVID-19 compared with other cancer survivors

COVID-19 Severity and Cardiovascular Outcomes in SARS-CoV-2-Infected Patients With Cancer and Cardiovascular Disease

BACKGROUND: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. OBJECTIVES: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. METHODS: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD RESULTS: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54-74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11-1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all CONCLUSIONS: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701)

Tears evoke the intention to offer social support: A systematic investigation of the interpersonal effects of emotional crying across 41 countries

Tearful crying is a ubiquitous and likely uniquely human phenomenon. Scholars have argued that emotional tears serve an attachment function: Tears are thought to act as a social glue by evoking social support intentions. Initial experimental studies supported this proposition across several methodologies, but these were conducted almost exclusively on participants from North America and Europe, resulting in limited generalizability. This project examined the tears-social support intentions effect and possible mediating and moderating variables in a fully pre-registered study across 7007 participants (24,886 ratings) and 41 countries spanning all populated continents. Participants were presented with four pictures out of 100 possible targets with or without digitally-added tears. We confirmed the main prediction that seeing a tearful individual elicits the intention to support, d = 0.49 [0.43, 0.55]. Our data suggest that this effect could be mediated by perceiving the crying target as warmer and more helpless, feeling more connected, as well as feeling more empathic concern for the crier, but not by an increase in personal distress of the observer. The effect was moderated by the situational valence, identifying the target as part of one's group, and trait empathic concern. A neutral situation, high trait empathic concern, and low identification increased the effect. We observed high heterogeneity across countries that was, via split-half validation, best explained by country-level GDP per capita and subjective well-being with stronger effects for higher-scoring countries. These findings suggest that tears can function as social glue, providing one possible explanation why emotional crying persists into adulthood.</p

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

Asthma-related outcomes associated with indoor air pollutants among schoolchildren from four informal settlements in two municipalities in the Western Cape Province of South Africa

The health impact of indoor air pollution in informal settlement households has not been extensively studied in South Africa. This cross-sectional study investigated the association between asthma and common indoor exposures among schoolchildren from four informal settlements located in two municipalities in the Western Cape Province. A total of 590 children, aged 9-11 years, were recruited. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was administered to caregivers. Pulmonary function assessment included spirometry and fractional exhaled nitric oxide (FeNO). Phadiatop test for atopy was done. The prevalence of doctor-diagnosed asthma was 3.4% (n = 20) among whom only 50% were on treatment. The prevalence of current wheeze was 12.9%, and 17.6% had airway obstruction (FEV; 1; &lt; lower limit of normal), while 10.2% had airway inflammation (FeNO &gt; 35 ppb). In adjusted logistic regression models, dampness, visible mold growth, paraffin use for cooking, and passive smoking were associated with a twofold to threefold increased risk in upper and lower airway outcomes. The strongest association was that of visible mold growth with rhinitis (adjusted odds ratio-aOR 3.37, 95% CI: 1.69-6.71). Thus, there is a need for improved diagnosis of childhood asthma and Indoor Air Quality in informal settlement households

Surface Pressure: Lived Experiences of Eldest Siblings who are Employed College Students

This thesis was conducted to explore the lived experiences of the University of Cebu's eldest siblings, who are employed college students. It discusses factors that have influenced them in working and studying simultaneously, the challenges they have encountered, and the strategies they used to overcome the difficulties. This research used a qualitative research method and was participated in by sixteen (16) informants from the College of Arts and Sciences, the College of Teacher Education, the College of Computer Studies, and the College of Criminal Justice. The researchers utilized snowball sampling and the non-probability sample technique of purposive sampling to select the participants. A semi-structured interview questionnaire consisting of open-ended questions was used to gather the participant’s data and was analyzed through a process called Thematic Analysis. The participants' responses established eight (8) emergent themes, classified into three (3) overarching themes that offered answers to the sub-problems. The participant’s important statements were then utilized to extract the emergent themes. The first overarching theme is Factors Influenced Employed College Students to Juggle Work and Studies. There were three (3) emergent themes regarding the influences that made the eldest siblings work while studying: Insufficient Financial Resources, Personal Goals, and Eldest Siblings and the Filipino Culture. The second overarching theme is the Challenges Met by the Participants, which mainly focuses on the struggles they have experienced. Under it are two (2) emergent themes: Challenges on Self-Management and Weakened Bonds and Relationships. The third overarching theme is the Coping mechanisms of the participants in dealing with the challenges met. These are the strategies for how the participants coped with the difficulties they had to face. Three (3) emergent themes were created: Personal Disposition, Organization of Tasks and Activities, and Self-Maintenance. The outcomes of this study were used to understand the lives of these individuals further and identify ways that may help them manage both work and studies as well as themselves

Short term seasonal effects of airborne fungal spores on lung function in a panel study of schoolchildren residing in informal settlements of the Western Cape of South Africa

The individual effects of biological constituents of particulate matter (PM) such as fungal spores, on lung function in children are not well known. This study investigated the seasonal short-term effect of daily variation in Alternaria and Cladosporium fungal spores on lung function in schoolchildren.; This panel study evaluated 313 schoolchildren in informal settlements of the Western Cape of South Africa, exposed to spores of two commonly encountered fungi, Alternaria and Cladosporium species. The children provided forced-expiratory volume in 1-s (FEV; 1; ) and peak-expiratory flow (PEF) measurements thrice daily for two consecutive school-weeks in summer and winter. Daily PM; 10; levels, from a stationary ambient air quality monitor and fungal spore levels using spore traps were measured in each study area throughout the year. The effects of Alternaria and Cladosporium spores, on lung function were analysed for lag periods up to five-days, adjusting-for PM; 10; , other pollen exposures, study area, and other host and meteorological factors. Same-day exposure-response curves were computed for both fungal species.; There was more variability in Alternaria spores level with noticeable peaks in summer. There were consistent lag-effects for Alternaria on PEF compared to Cladosporium, with the largest PEF deficit observed in winter (mean deficit: 13.78 L/min, 95%CI: 24.34 to -3.23 L/min) per 10spores/m; 3; increase in Alternaria spores on lag day-2. Although there were no observable lag-effects for Alternaria and Cladosporium on FEV; 1; , same-day effects of Cladosporium spores on FEV; 1; was present across both seasons. Threshold effects of Alternaria on both PEF and FEV; 1; deficits were apparent at levels of 100 spores/m; 3; , but could not be explored for Cladosporium beyond the levels observed during the study.; The study provides evidence for the independent effects of daily exposure to ambient fungal spores of Alternaria and Cladosporium on lung function deficits, more especially in winter for PEF

The association between ambient NO2 and PM2.5 with the respiratory health of school children residing in informal settlements: a prospective cohort study

No previous epidemiological study has investigated the combined association of long-term ambient nitrogen dioxide (NO; 2; ) and particulate matter of diameter size-2.5 (PM; 2.5; ) exposure with asthma outcomes among schoolchildren in Africa.; This study investigated the independent and co-pollutant association of long-term exposures to ambient air pollutants on asthma-associated outcomes in a cohort of schoolchildren in the Western Cape Province of South Africa.; A total of 590 grade-4 schoolchildren residing in four informal settlements were studied. Spirometry and fractional exhaled nitric-oxide (FeNO) measurements were conducted, including a standardized questionnaire administered to caregivers at baseline and 12-months follow-up. Annual NO; 2; and PM; 2.5; levels were estimated for each child's home using land-use regression modelling. Single- and two-pollutant models were constructed to assess the independent and co-pollutant association of both air pollutants (NO; 2; and PM; 2.5; ) on new cases of asthma-associated outcomes adjusting-for host characteristics, indoor exposures and study area.; The annual average concentration of PM; 2.5; and NO; 2; were 10.01μg/m; 3; and 16.62μg/m; 3; respectively, across the four study areas, and were below the local Standards of 20μg/m; 3; and 40μg/m; 3; , for both pollutants, respectively. In the two-pollutant-adjusted models, an interquartile range (IQR) increase of 14.2μg/m; 3; in NO; 2; was associated with an increased risk of new onset of ocular-nasal symptoms (adjusted odds ratio-aOR: 1.63, 95% CI: 1.01-2.60), wheezing (aOR: 3.57, 95% CI: 1.18-10.92), more than two or more asthma symptom score (aOR: 1.71, 95% CI: 1.02-2.86), and airway inflammation defined as FeNO > 35 ppb (aOR: 3.10, 95% CI: 1.10-8.71), independent of PM; 2.5; exposures.; This study provided evidence that ambient NO; 2; levels below local standards and international guidelines, independent of PM; 2.5; exposure, increases new cases of asthma-associated outcomes after 12-months